Abstract: SA-PO506
Nephrolithiasis as a Risk Factor for Kidney Disease Progression in ADPKD
Session Information
- ADPKD: Clinical Studies
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidney
- 1001 Genetic Diseases of the Kidney: Cystic
Authors
- Gitomer, Berenice Y., Div. Renal Diseases and Hypertension,, Aurora, Colorado, United States
- You, Zhiying, UC Denver, Aurora, Colorado, United States
- Wang, Wei, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Brosnahan, Godela M., University of Colorado Denver, Aurora, Colorado, United States
- Nowak, Kristen L., University of Colorado Denver: Anschutz Medical Campus, Aurora, Colorado, United States
- Hopp, Katharina, University of Colorado Denver, AMC, Aurora, Colorado, United States
- Harris, Peter C., Mayo Clinic, Rochester, Minnesota, United States
- Torres, Vicente E., Mayo Clinic, Rochester, Minnesota, United States
- Chapman, Arlene B., University of Chicago, Chicago, Illinois, United States
- Perrone, Ronald D., Tufts Medical Center, Boston, Massachusetts, United States
- Steinman, Theodore I., Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
- Yu, Alan S.L., University of Kansas Medical Center, Kansas City, Kansas, United States
- Bae, Kyongtae Ty, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Abebe, Kaleab, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Chonchol, Michel, University of Colorado, Aurora, Colorado, United States
Background
Kidney stones are a frequent complication among patients with autosomal dominant polycystic kidney disease (ADPKD). Previous studies have shown a higher risk of incident chronic kidney disease in persons with a history of kidney stones, but these studies did not examine patients with ADPKD. Thus, we hypothesized that a history of kidney stones may affect the rate of kidney function decline or increase in height corrected total kidney volume (HtTKV) in patients with ADPKD.
Methods
We assessed the association between a history of nephrolithiasis and annual rate of eGFR decline or % increase HtTKV using linear regression in 898 HALT-PKD study participants. To better ensure the temporal relation between nephrolithiasis and kidney function decline, we required that eGFR measurements were at least 180 days after the date of the kidney stone ascertainment. Analyses were adjusted for age, sex, body mass index, randomization group, baseline eGFR, systolic blood pressure, albumin excretion and genotype.
Results
A total of 898 subjects (mean age 43±10 years), comprising 789 non-stone forming (NKS) subjects and 109 subjects (46 with eGFR > 60 and 63 with eGFR 25-60 ml/min/1.73m2 at baseline) with kidney stones (KS) and complete data were included in the analysis of eGFR decline. Baseline eGFR was 70±26 ml/min/1.73m2 in the NKS group and 70±28 ml/min/1.73m2 in the KS group (p= 0.9). Stone forming patients had a significantly faster yearly rate of kidney function decline of -5.3 ±8.3 ml/min/1.73m2 vs. NKS -3.6±4.1 ml/min/1.73m2 after adjustment for all variables (p<0.001). A total of 435 subjects (mean age 37±8.3 years), comprising 389 NKS (HtTKV 710±413 ml) and 46 KS (HtTKV 727±449ml) were included in the analysis of kidney volume progression. There was no significant difference in the rate of increase in HtTKV between the NKS and KS groups.
Conclusion
The presence of kidney stones was associated with more rapid loss of kidney function, thus may be a risk factor for more rapid kidney disease progression in ADPKD. As there were fewer subjects and imaging measures over the course of the HALT-PKD study this may confound ability to detect an effect of kidney stones on the rate of increase in HtTKV.
Funding
- NIDDK Support